Melanoma of the small bowel: primary or metastatic? a clinical case

Authors

  • Antonia A. Póvoa Interna Complementar de Cirurgia Geral – Serviço de Cirurgia Geral do Centro Hospitalar de Vila Nova de Gaia, Portugal
  • Antónia M. Furtado Interna Complementar de Anatomia Patológica – Serviço de Anatomia Patológica do Centro Hospitalar de Vila Nova de Gaia, Portugal
  • Carlos Soares Assistente Hospitalar de Cirurgia Geral – Serviço de Cirurgia Geral do Centro Hospitalar de Vila Nova de Gaia, Portugal
  • Eduardo Vasconcelos Assistente Hospitalar de Cirurgia Geral – Serviço de Cirurgia Geral do Centro Hospitalar de Vila Nova de Gaia
  • Rosete Nogueira Assistente Hospitalar Graduada de Anatomia Patológica – Serviço de Anatomia Patológica do Centro Hospitalar de Vila Nova de Gaia, Portugal
  • Lurdes T. Gandra Assistente Hospitalar Graduada de Cirurgia Geral – Serviço de Cirurgia Geral do Centro Hospitalar de Vila Nova de Gaia, Portugal
  • Jorge Maciel Chefe de Serviço de Cirurgia Geral – Serviço de Cirurgia Geral do Centro Hospitalar de Vila Nova de Gaia, Portugal

Abstract

Malignant melanoma often originated from melanocytes can occur wherever these cells are present. Most common locations are the skin, retina, anus and under the nail. Although rare, primary gastrointestinal tract melanoma has been reported, mostly from the oesophagus and anorectal region. In the small bowel represents 5% of primary neoplasms. We report a case of a 70 year old man, who presented with abdominal pain, weigh loss and anaemia. Based on the findings of CT, endoscopy and entheroscopy a preoperative diagnosis of a small bowel tumour was established. Was submitted to a multiple segmental enterectomy, the histopathological examination revealed a malignant melanoma. A thorough postoperative investigation did not reveal a primary lesion in the skin, oculus or any other location. Brain and pulmonary metastasis where diagnosed afterwards and he died three months after surgery. In a patient without any obvious primary tumour, with a gastrointestinal melanoma and without extraintestinal lesions we should rule out primary gastrointestinal melanoma.

Keywords: Malignant melanoma, small bowel, gastrointestinal tract. 

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Published

2008-09-27

Issue

Section

Clinical Case